Anderson MOPS 2016-17 Registration Form
First Name:
Your answer
Last Name:
Your answer
Phone Number:
(Please indicate if this is cell, home or other
Your answer
Email Address:
Your answer
Mailing Address:
(Street, City, State, Zip)
Your answer
Birthday:
MM
/
DD
Have you ever attended a MOPS meeting before?
If so, what MOPS group did you attend?
(ex. Anderson MOPS, Easley MOPS, etc)
Your answer
Do you attend church?
If so, what church do you attend?
Your answer
How did you hear about Anderson MOPS?
(if a MOPS member invited you, please list her name if possible)
Your answer
If a picture is taken of you &/or your kiddos at a MOPS event, do we have your permission to share it on our blog or facebook page?
How many children will you be enrolling in our MOPPETS childcare program?
(If you have other childcare arrangements during MOPS meetings, please choose "0" below. If you are bringing children to the Anderson MOPS meetings, please be sure to register them for our MOPPETS program.)
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